1.4 Lesson 4: New Trichological Research – Pay By Chapter
- The World Trichology Society’s course keeps you up-to-date with all the new research in the fields of trichology and dermatology. Below are some examples:
- Researchers Hone In On Vitamin D's Role In Hair Growth.
- A considerable portion of the research on baldness prevention is now honing in on the role of vitamin D in hair growth. A receptor to which the vitamin binds is responsible for activating hair growth. In a study published in the Journal of Investigative Dermatology, researchers reported that a molecule called MED is associated with suppression of the receptor's actions. Mice without MED appeared to grow more hair, thus providing researchers a future target for hair replacement therapies. Other scientists, in a paper published in the Journal of Biological Chemistry, discovered that the LEF1 molecule also can cause activation of the vitamin D receptor without vitamin D even being present.
- Researchers say low level of certain enzymes may cause hair to turn gray.
- A study published in the Federation of American Societies for Experimental Biology Journal may explain how "hair grays with age." Researchers from the University of Bradford in the UK "closely examined cell cultures of human hair follicles and found in the absence of the enzyme catalase, the hydrogen peroxide naturally produced in hair cells stops being broken down into water and oxygen," with the hair follicles being unable to "repair the damage...because of low levels of enzymes MSR A and B." The low enzyme levels "disrupted the formation of the enzyme tyrosinase that leads to the production of the melanin which colors hair."
- Researchers Develop Method To Trigger Growth Of New Hair.
- Scientists have developed what might become a better way to transplant hair. Researchers found that by clustering hair cells together in a lab and then transplanting them in human skin grafted to a mouse, hair grew. Current methods for treating baldness do not stimulate the growth of new hair. Meanwhile, hair transplants simply take hair from one part of the head and put it in another place. Investigators took papilla cells from seven men who were undergoing hair transplants, cultured them in hanging drops and then injected them into human skin grafted onto mice. The investigators made the grafts from a type of skin that is normally 100 percent hairless – foreskins from circumcised infants. The researchers found that new hair follicles grew in five of the seven grafts. DNA analysis confirmed that the new hair follicles genetically matched the human donors. The research was published online in the Proceedings of the National Academy of Sciences. However, the hair follicles weren’t normal, as they were missing sebaceous glands that keep the skin moist. Additionally, the hair grew out of the skin at funny angles. Still, this discovery takes a huge leap forward in the potential for developing new drugs to treat hair loss. Additional research will be required before humans can be treated with this protocol, the researchers said.
- Prostaglandin D2 inhibits hair growth and is elevated in bald scalp of men with androgenetic alopecia.
- Recent evidence demonstrates a role of prostaglandins in regulating hair growth. The authors illustrate that prostaglandin D2 synthase (PTGDS) is elevated at the mRNA and protein levels in bald scalp compared to haired scalp of men with androgenetic alopecia (AGA). Levels of the product of PTGDS enzyme activity, prostaglandin D2 (PGD2), were also elevated in bald scalp. During normal follicle cycling in mice, PTGDS and PGD2 levels peaked in late anagen, immediately preceding the regression phase, suggesting an inhibitory effect on hair growth. PGD2 inhibited hair growth in explanted human hair follicles and when applied topically to mice. Hair growth inhibition requires the PGD2 receptor G protein-coupled receptor 44 (GPR44), but not the PGD2 receptor 1 (PTGDR). Furthermore, K14-Ptgs2 transgenic mice, which overexpress prostaglandin-endoperoxide synthase 2 in the skin, demonstrate elevated levels of PGD2 in the skin and develop alopecia, follicular miniaturization, and sebaceous gland hyperplasia, as seen in human AGA. These results define PGD2 as an inhibitor of hair growth in AGA and suggest the PGD2-GPR44 pathway as a potential target for treatment.
- Does exercise influence skin aging, skin health, or androgenetic alopecia?
- A recent letter published in JAAD explored the correlation between exercise and various dermatologic conditions, including skin aging, skin health, and androgenetic alopecia. The authors found that regular high-intensity aerobic exercise more than four hours per week reduced thinning of the stratum corneum and increased Pgc-1a expression, a mitochondrial regulator indicative of decreased aging of cells. Vigorous exercise was associated with a 25% to 30% reduced risk of psoriasis. Physical activity was also associated with improved healing of venous ulcers. There was insufficient evidence that exercise prevents skin cancer or worsens androgenetic alopecia.
- Oral Minoxidil Well-Tolerated In Patients With Alopecia
- In an interview with Dermatology World, Antonella Tosti, MD, discussed her recent findings published in JAAD showing that oral minoxidil is well tolerated in patients with hair loss. She said, “The most common side effect is hypertrichosis, but only a few patients decided to interrupt the treatment because of that (0.5% of cases).” Tosti added, “I am increasingly using oral minoxidil as I feel more confident about tolerability. It improves the hair density overall and is useful in all types of alopecia in association with other treatments.”
- Biotin Supplementation Rarely Necessary
- In the latest “Insight and Inquiries” post in Dermatology World, Warren R. Heymann, MD, FAAD writes on the use and necessity of biotin. He says, “Biotin (vitamin B7, vitamin H, coenzyme R) is a water-soluble vitamin that acts as a coenzyme of four kinds of carboxylase...in mitochondria, facilitating three major metabolic reactions,” and that it is recommended that people take “30 μg/day of biotin, and a normal Western diet consists of 35 to 70 μg/day.” Supplementing that amount “is only rarely necessary, that being in congenital and acquired cases of biotin deficiency.” In these cases, symptoms appear as “alopecia, eczematous skin rashes, seborrheic dermatitis, conjunctivitis, and multiple neurological symptoms, such as depression, lethargy, hypotonia, and seizures.” He concludes by saying, “to date there is no evidence that it promotes hair and nail growth or quality in otherwise healthy patients,” and “patients must be warned that biotin supplementation could adversely affect streptavidin/biotin-based laboratory assays.”
- Frontal fibrosing alopecia and facial care products
- A study published in The Journal of Dermatology sought to investigate whether there may be an association between the use of facial care products and frontal fibrosing alopecia (FFA) in Asian females. The authors sent a survey to 50 FFA patients, 100 pattern hair loss patients, and 100 controls, inquiring about their use of facial care products and hair care practices. The use of facial moisturizer was significantly higher in the FFA group than in the control group (78% vs. 40%), and the use of sunscreen was significantly higher in the pattern hair loss group than in the control group (72% vs. 35%). Subjects in the FFA and pattern hair loss groups reported more frequent use of both sunscreen and moisturizer compared with normal controls. The authors suggest, however, that the use of facial care products, particularly moisturizer and sunscreen, may not be truly associated with FFA. The increased rate of facial care product use in patients diagnosed with hair disorders may not be linked to the disease mechanism of FFA, but rather to appearance-related concerns of patients.
- A review of spironolactone for androgenetic alopecia
- In a study published in JAAD, the authors reviewed 12 studies in which participants used spironolactone for androgenetic alopecia. Spironolactone was the sole therapy for 23% of the participants while the rest used the drug in combination with topical minoxidil, oral minoxidil, low-level laser therapy, or iron supplementation. Doses of spironolactone ranged between 25 and 200 mg for a duration of six month to four years. With the monotherapy, about half of patients achieved improvement in follicular density and hair loss. Spironolactone was ineffective at doses less than 100 mg; rather, improvement was reported after at least 12 months of 100 to 200 mg daily.
- CICATRICIAL ALOPECIA FOLLOWING ACD FROM HAIR DYE (FROM AMERICAN ACADEMY OF DERMATOLOGY)
- A case report published in Contact Dermatitis reveals what may be the first known case of acute lichenoid allergic contact dermatitis leading to cicatricial alopecia from hair dyes that contain PPD. A 30-year-old woman who dyed her hair every two to three months presented with violaceous pigmentation of the scalp, adjacent forehead, and superolateral portions of the ears with patchy, scarred hair loss of the scalp and forehead. The last application of hair dye was six months before presentation and led to itchy, oozing plaques on the scalp, forehead, and ears. A biopsy showed cicatricial (lichenoid) alopecia with pigmentation. Patch testing was notable for a very strong reaction to paraphenylenediamine (PPD) 1% pet. The diagnosis was allergic contact dermatitis (ACD) resulting from the hair dye.